Registry details
Type
Individual
Primary specialty
Physician Assistant
Enumerated
Sep 16, 2024
License(s)
5601012663 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 4660 S HAGADORN RD STE 420 | East Lansing, MI 48823-5353 | 517-884-6100 |
| MAILING | 804 SERVICE RD STE A202 | East Lansing, MI 48824-7015 | 517-884-6100 |
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